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NUR 333 > E4 Bowel Elimination > Flashcards

E4 Bowel Elimination Flashcards

(59 cards)

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1
Q

Factors influencing bowel elimination

A

-Age
-Diet
-Fluid intake
-Physical activity
-Psychological factors (going in public or ritualistic about going)
-Personal habits
-Positioning during defecation
-Pain
-Pregnancy
-Surgery & Anesthesia
-Medications
-Diagnostic tests

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2
Q

Older adult care focus for bowel elimination

A

-Trouble chewing
-Esophageal emptying slows
-Impaired absorption
-Weakened sphincters

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3
Q

Older adults have decreased

A

-Hydrochloric acid (start of food breakdown)
-Absorption of vitamins
-Peristalsis (motility of GI)
-Sensation to defecate
-Lipase to aid in fat digestion

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4
Q

Constipation is a ______ - not a _______

A

symptom
disease

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5
Q

Constipation is having ______ bowel movements a week

A

3

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6
Q

Symptoms of constipation

A

-Infrequent BMs
-Discomfort
-Hard, dry stools difficult to pass

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7
Q

Causes of constipation

A

-Irregular Bowel Habits
-Improper diet-fiber
-Reduced fluid intake
-Lack of exercise
-Stress
-Certain meds
-Advanced age
-ignoring the urge to defecate
-GI disorders

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8
Q

Older adults & constipation

A

-Lack of muscle tone
-Slowed peristalsis
-Lack of exercise
-Inadequate fluid intake
-Too many dairy products
-Lack of fiber
-Medications

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9
Q

What does slowed peristalsis do?

A

Gives water more time to be reabsorbed making stool hard and firm

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10
Q

Complications of constipation

A

-Hemorrhoids
-Anal fissures
-Fecal impaction
-Rectal prolapse

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11
Q

Constipation prevention

A

-Include plenty of high fiber foods
-Drink plenty of fluids
-Stay active
-Manage stress
-Don’t ignore urge to go
-Create a schedule

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12
Q

What are the common types of laxatives & cathartics

A

-Bulk forming
-Emollient or Wetting
-Osmotic
-Stimulant Cathartics

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13
Q

Bulk forming laxatives

A

-Most natural treatment
-Methylcellulose
-Pyslliumm
-Polycarbophil

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14
Q

Emollient & Wetting Laxatives

A

-Stool softner
-Lower surface tension of feces
-Docusate Sodium

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15
Q

Osmotic laxatives

A

-Stimulants
-Increase peristalsis & pull fluid back into bowel
-Saline-based
-Magnesium Citrate
-Magnesium Hydroxide
-Sodium Phosphate
-Polyethylene
-Lactulose

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16
Q

Stimulant cathartics

A

-Bisacodyl
-Senna

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17
Q

How to use and what are cathartics & laxatives?

A

-Meds that initiate stool passage
-PO or Rectal suppositories
-Short term
-May be used to cleanse the bowel for a GI dx test, procedure, or surgery
-Potential harmful effects if overused

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18
Q

Treatment order for constipation

A
  1. Bulk forming agents
  2. PO meds such as stool softners or laxatives
  3. Suppository
  4. Enema
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19
Q

Enema Nursing Care

A

-Verify order
-Gather equipment
-Position in Left Lateral Sims
-Teach pt to hold in as long as possible
-If pt cramps or has pain slow rate by lowering height of bag
-If abdomen rigid STOP
-Document amount of enema given

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20
Q

Enema precautions/ complications

A

-Fluid & electrolyte imbalance
-Tissue trauma
-Vagal nerve stimulation
-Abdominal pain/ cramping
-Pain
-Perforation

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21
Q

Impaction results from

A

unrelieved constipation and the inability to expel the hardened feces retained in the rectum

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22
Q

If impaction is not resolved can lead to

A

intestinal obstruction

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23
Q

What individuals are most at risk for impaction?

A

-Debilitated (spinal cord injury)
-Confused
-Unconscious

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24
Q

Impaction symtoms

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A

-Inability to pass stool for several days despite repeated urge to defecate
-Continuous oozing of liquid stool
-Loss of appetite
-N/V
-Abdominal distention
-Cramping
-Rectal pain

25
Digital removal of stool
-Assess -Digital removal of stool -Nurses use finger to break up fecal mass and removes it in sections -Very painful -Risks involved (tissue damage & vagal nerve
26
What is diarrhea?
Loose, watery bowel movements -Can happen frequently and with urgency
27
Common causes of diarrhea
-Foodborne pathogens -Food intolerance & allergies -Surgery -Diagnostic testing -Enternal feeding (tube feeding intolerance)
28
Common complications of diarrhea
-Skin irritation -Dehydration -Nutritional concerns
29
Antidiarrheal agents
-Decrease intestinal muscle tone to slow the passage of feces -Body absorbs more water -Must determine cause of diarrhea -Ex. loperamide & diphenoxylate
30
Nursing care for Diarrhea
-Identify problem & eliminate -Provide soft easily digestible food (Bland like chicken and rice) -Does not mean to place on clear liquids -Maintain fluid & electrolyte balance -Prevent spread with hand hygiene
31
Nursing interventions for management of fecal incontinence & diarrhea
-Meticulous skin care -Prevention & monitoring for dehydration -Fecal management systems
32
Nursing interventions: Maintenance of skin integrity
-Meticulous skin care -Frequent checks -Apply skin barrier -Consult WOCN
33
Who is at risk for C-diff?
-Antibiotics -Elderly -Immunocompromised -Long-term care facility -GI procedure -Previous Cdiff
34
C-diff complications
-dehydration -kidney failure -toxic megacolon -bowel perforation -death
35
C-diff prevention
-Wash hands with soap & water -Avoid unnecessary use of antibiotics -Clean surfaces with bleach -Place in isolation
36
Treatment of C-diff
-Plenty of fluids & nutrition -Antibiotics -Surgery -Fecal implantation -Probiotics
37
Causes of incontinence
-Muscle nerve damage -Any physical condition that impairs the anal sphincter function -Constipation & diarrhea -Large volume of stools -Surgery -Rectal prolapse
38
RIsk factors of bowel incontinence
-Age -Female -Nerve damage -Dementia -Physical disability
39
Treatment of bowel incontinence
Anti-diarrheals or Bulk laxatives
40
Prevention of bowel incontinence
-Reduce constipation -Control diarrhea -Avoid straining
41
What is faltulence?
Passing Gas by burping or tooting
42
Symptoms of flatulence
-Abdominal distention -Cramping -Bloating -Pain
43
Causes of flatulence
-Constipation -Food intolerance -GI distress -Stress
44
Nursing care for flatulence
-Avoid foods that cause gas (avoid soluble fiber) -Eat small, more frequent meals -Eat & drink slowly -Avoid straws -Avoid laying down after eating -Limit carbohydrates -Limit carbonated drinks -Drink water & exercise
45
What foods should be avoided for flatulence?
Soluble fibers- black beans, lima beans, broccoli, turnips, brussel sprouts, avocado
46
Hemorrhoids: what are they and treatment
-Dilated or engorged veins in lining of rectum -Treatment: Treat cause like constipation, topical creams, warm sitz baths, surgery
47
Causes of hemorrhoids
-Increased venous pressure from straining -Pregnancy -Liver disease -Heart failure -Sitting on toilet for longtime
48
What is the 2nd leading cause of cancer death in U.S.?
Colon Cancer
49
Risk factors of Colon cancer
-African American -Diet: High intake of red meat or processed meats, low fiber -Obesity -50+ -Lack of physical activity -Alcohol, tobacco use -Family hx -Hx of inflammatory bowel disease
50
Colon cancer screening
-Begin screening at age 45 than depends on results & family hx for how often -DNA & occult test but not as accurate as a scope -Flex sigmoid Q5 -Colonoscopy Q10
51
If a fecal specimen sterile?
No
52
Fecal Occult Blood Test
-Check for hidden blood -Ordered to detect cancer or evaluate possible causes of unexplained anemia -Stool sample from 2 diff areas -Often ordered for 3 different occurrences -Be aware of false positives (redmeat)
53
Goal for Bowel elimination issues
Patient will have normal bowel elimination patterns
54
Purpose of NG tube
-Decompression (keep things out of stomach) -Enteral feeding or medication -Administration -Lavage
55
Assessment of NG tube
-Abdominal -Respiratory -Nose/skin integrity -Tube (cm tube at) -Suction (what drainage looks like, low wall suction)
56
Nursing care of NG tube
-Verify HCP orders -Assessment -Verify placement (pH strip & X-ray) -Know how to hook to suction -Administration of feedings & medications -Recording I&Os
57
Bowel training
-Pts with chronic constipation or fecal incontinence -Set up daily routine -Requires time, patience, & consistency -Choosing patient-centered time -Offer fluids -Assist to comode -Exercise & Privacy
58
Diet recommendations
Whole grains, legumes, fresh fruit, Veggies Fiber intake varies per individual (increase fluid with it)
59
Older adult considerations
-Encourage screening -Adequate fiber & fluid intake -Regular exercise program -Older adults are less able to compensate from fluid loss from diarrhea

NUR 333 (15 decks)

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